Ozyurt Abdullah, Karpuz Derya, Yucel Aydin, Tosun Mehtap Durukan, Kibar Ayse Esin, Hallioglu Olgu
Department of Pediatric Cardiology, Ministry of Health, Mersin Woman's and Children's Hospital, 33240, Toroslar-Mersin, Turkey.
Department of Pediatric Cardiology, Mersin University School of Medicine, Mersin, Turkey.
Cardiovasc Toxicol. 2017 Jul;17(3):326-334. doi: 10.1007/s12012-016-9389-4.
The aim of the current study is to investigate the effects of CO (carbon monoxide) on the cardiovascular system via electrocardiographic, echocardiographic and biochemical findings in children. This prospective study included 22 children with CO poisoning and 24 healthy children as a control group. The CO-intoxicated children were evaluated via electrocardiography and echocardiography 1 h after admission to the emergency department and daily until their discharge from the hospital. Blood gasses, complete blood account, troponin I and creatinine kinase-MB(CK-MB) were assessed daily. Tpeak-end (p:0.001), QTc durations (p:0.02), Tpeak-end dispersion (p:0.001) and Tpeak-end/QT ratio (p:0.001) of CO-intoxicated patients were significantly higher than those in the control group. Mitral E duration (p:0.001), mitral E/A ratio (p:0.001) and left ventricle contractile fraction (p:0.023) at admission were significantly lower, and left ventricle myocardial performance index was higher (p:0.001) in the CO poisoning group. Troponin I and CK-MB levels were higher at admission in 6 (27 %) and 4 (18 %) patients, respectively. The heart is the most critical organ in pediatric CO poisoning. These children present subclinical systolic and diastolic left ventricle dysfunction even in mild cases. Although, in children with acute CO-intoxication ventricular repolarization is impaired, it seems to be reversible like other findings.
本研究的目的是通过儿童的心电图、超声心动图和生化检查结果，探讨一氧化碳（CO）对心血管系统的影响。这项前瞻性研究纳入了22名一氧化碳中毒儿童和24名健康儿童作为对照组。一氧化碳中毒儿童在急诊科入院后1小时通过心电图和超声心动图进行评估，并在出院前每天进行评估。每天评估血气、全血细胞计数、肌钙蛋白I和肌酸激酶同工酶（CK-MB）。一氧化碳中毒患者的T峰末间期（p:0.001）、QTc间期（p:0.02）、T峰末离散度（p:0.001）和T峰末/QT比值（p:0.001）显著高于对照组。一氧化碳中毒组入院时二尖瓣E峰持续时间（p:0.001）、二尖瓣E/A比值（p:0.001）和左心室收缩分数（p:0.023）显著降低，左心室心肌性能指数较高（p:0.001）。入院时分别有6名（27%）和4名（18%）患者的肌钙蛋白I和CK-MB水平升高。心脏是小儿一氧化碳中毒最关键的器官。即使在轻度病例中，这些儿童也存在亚临床收缩期和舒张期左心室功能障碍。虽然急性一氧化碳中毒儿童的心室复极受损，但与其他发现一样，似乎是可逆的。
